Information concerning team staffing, keyworker case-loads, and keyworker diagnostic case-mix was collected from six community mental health teams caring for 1651 patients to establish the clinical burden across teams and professions.

Team case-loads varied from 427 to 121, an average of 275 patients. Over half the patients were female, and psychotic disorders constituted 44% of the sample. The most common diagnoses were schizophrenia (28.6%) and depression (23.6%). Keyworker case-loads varied across both teams and professions, averaging 30 patients per full-time equivalent. Psychiatrists' case-loads were the largest. Diagnostic case-mix varied with profession. Community psychiatric nurses had the largest proportion of patients with psychosis (73.8%).

Multi-disciplinary community mental health teams have a shared view of appropriate work distribution. Consultant psychiatrists may underestimate the resources required by patients with non-psychotic disorders even in inner city areas.

To assess what medication information long-term mentally ill patients required and acceptability of an advice service. Confidential consultations were offered by a community pharmacist at two mental health resource centres. The service was evaluated by patients and staff by questionnaire.

Data were collected on 33 consultations (30 users; three attended twice). Mean duration of consultations was 14.9 minutes (range 5–45). Antipsychotics and antidepressants were most commonly prescribed and enquired about. Most drug enquiries concerned adverse drug reactions (n=24) and therapy choice (n=17). All patients and staff hoped the service would be fully implemented.

Community pharmacists represent an acceptable, but underutilised, information provision service. Such a service could be overseen by specialist psychiatric pharmacists. This study reflects patients' concerns about the use of antipsychotics and antidepressants and the need to address them. Further work is needed to determine the impact of the service on clinical outcome.

A retrospective case note study provided data on the service consumption and outcome of treatment for a cohort of adult anorexia nervosa sufferers treated in a specialised secondary service.

A cohort of 106 patients was studied. Only just over a quarter were ever admitted. Of a subset of 78 patients, first seen before 1994, nearly one-fifth failed to engage in treatment. Those who were admitted spent on average a total of 10 months in hospital, were in touch for four years and had over 100 therapy sessions. The majority who were treated solely as out-patients remained in touch with the service on average for over two years.

Services for anorexia nervosa sufferers need to plan for prolonged contact with their patients and high rates of service consumption.

Electroconvulsive therapy should be effectively monitored and seizure duration accurately ascertained. We observed the seizure duration in both lower and upper limbs using the Hamilton ‘cuff’ method.

Thirty-nine seizures in 19 patients were observed. There were no statistically significant differences between cuffed and uncuffed limbs, nor between upper and lower limbs.

Alternatives to the Hamilton cuff method to observe seizure duration need to be considered.

Changes in higher specialist training in the UK have led to a revision of training guidelines in child and adolescent psychiatry. This survey studies trainees' experiences and attitudes in the light of these changes. A questionnaire covering training attitudes and experiences was distributed to all higher specialist trainees in child and adolescent psychiatry via their programme directors.

Eighty-eight per cent of trainees responded. Although most training experiences are well provided, there are gaps in provision in specific areas, including research and teaching. Dissemination of information about aspects of training requires improvement and clearer feedback on training could be given.

The implications for training in child and adolescent psychiatry and higher specialist training in general are discussed.

The number of drivers on our roads with dementia is likely to increase as the elderly population grows. We performed a retrospective analysis of patients referred to our Memory Clinic in Taunton who were still driving despite a high suspicion of dementia.

Twenty per cent of the patients were still driving at the time of their assessment. Ten per cent had a diagnosis of Alzheimer's disease and 10% mild cognitive impairment. The patients and/or carers stated that the patient had not been told to stop driving and none of the referral letters documented any advice about driving.

Referrers should advise all patients with possible dementia to refrain from driving until assessment by a specialist team is completed. They should be informed of the risk of medico-legal consequences if they continue to drive.